Insurance, Health, Accident - As introduced, requires Tennessee advisory commission on intergovernmental relations (TACIR) to conduct an evaluation examining the frequency at which health insurers deny healthcare claims or reimbursements for policyholders and healthcare providers and an evaluation of related data for the past five calendar years; requires TACIR to report its findings to the appropriate standing committees of the general assembly by January 15, 2026. - Amends TCA Title 4, Chapter 10 and Title 56.

114th Regular Session (2025-2026) Introduced by Todd Gardenhire

Tennessee requires a state commission to investigate health insurance claim denials over five years and report findings by January 2026 to inform potential future policy decisions.

Assigned to General Subcommittee of Senate Commerce and Labor Committee

#accident #health #insurance

Legislative bill overview

SB 1134 directs Tennessee's Advisory Commission on Intergovernmental Relations (TACIR) to investigate how frequently health insurers deny claims or reimbursements over the past five years and report findings to the state legislature by January 15, 2026. The bill requires comprehensive data collection and analysis on denial patterns affecting both policyholders and healthcare providers.

Why is this important

Claim denials significantly affect patients' access to care and financial security, while also impacting healthcare providers' operational costs. Currently, Tennessee lacks centralized, systematic data on denial frequencies and patterns, making it difficult for policymakers to identify whether insurers are inappropriately denying coverage or if denials serve legitimate purposes. This study would provide the foundation for potential future regulatory action.

Potential points of contention

Data collection burden: Insurers may argue that compiling five years of detailed denial data is administratively costly and may request exemptions or extensions

Privacy and competitive concerns: Insurance companies could resist sharing detailed denial information, citing proprietary business concerns or patient privacy issues

Scope limitations: The bill doesn't specify whether denials include non-emergency services, experimental treatments, or other categories, potentially creating disputes over what data to include

Timeline feasibility: Collecting and analyzing five years of data across multiple insurers by January 2026 may prove unrealistic given typical government study timelines

Lack of enforcement mechanism: The bill requires a report but contains no subsequent authority to act on findings, limiting its practical impact